State Health Policy

The number of urgent care centers in the United States is rapidly growing. According to an urgent care trade association, the number of centers grew by five percent between 2016 and 2017, from 7,271 to 7,639. Additionally, the number of private insurance claim lines for urgent care centers (i.e., the individual procedures listed on an insurance claim) increased by 1,725 percent between 2007 and 2016, more than seven times the growth of emergency room claim lines in the same period. Poor access to primary care, overburdened primary care providers, and emergency room wait times and overcrowding are seen as contributing factors to the increase in urgent care centers over the last five years. Read More »

Over the past couple of years, rising health concerns related to per- and polyfluoroalkyl substances (PFAS) have resulted in state policymakers taking action to reduce, monitor, and regulate PFAS exposure. For example, Michigan’s efforts to test all of the state’s water systems for PFAS revealed alarming levels of PFAS in the drinking water of one township and led to a declared state emergency. Read More »

The high cost of prescription drugs is a persistent problem in the United States, with about 10 percent of overall health spending attributed to prescription drugs. In recent years, there has been increased interest among states to address the rising cost of prescription drugs. Just this year, 24 states passed 37 bills to stem rising drug costs. In total, state legislatures have introduced 160 bills targeting prescription drug costs in 2018. Read More »

On Aug. 6, the world mourned the death of Margaret Heckler, the former HHS secretary under President Ronald Reagan who worked to prioritize health disparities and social determinants of health. In 1985, Heckler commissioned the landmark Report of the Secretary’s Task Force on Black and Minority Health. Now commonly known as the Heckler report, this assessment highlighted the disproportionate burden of death and illness impacting racial and ethnic minorities and initiated a taskforce to improve the health of minorities and eliminate health disparities, the first of its kind by the federal government. Read More »

Maternal mortality rates in the United States continue to rise, with ethnic and racial minority populations facing even starker statistics. Policymakers are pursuing a variety of approaches to improve perinatal and postnatal care to support healthy and safe pregnancies, including expanding access to doula services. A doula is a trained professional that provides continuous physical, emotional, and informational support during and shortly after childbirth. Through this continuous support system, doulas positively impact both mothers and babies, as well as help families achieve a healthy and positive birthing experience. For women at-risk for adverse birth outcomes because of racial disparities, doula care can provide positive benefits and improve factors that mediate mortality, including decreasing cesarean births, operative vaginal births, use of analgesics, and duration of labor. Read More »

Sepsis occurs when a body’s immune system overwhelmingly responds to an infection and triggers widespread inflammation. The inflammation leads to blood clots and leaky vessels which can result in organ damage and death. Sepsis can be caused by a wide range of infections, but those most commonly linked to sepsis are infections found in the lungs, kidneys, skin, and gut. Sepsis can also result from a range of pathogens. Most commonly, however, the specific pathogen is not identified in 30 to 70 percent of patients with sepsis. In addition, sepsis occurs in patients across the lifespan, most commonly in those over 65 and under the age of one. Sepsis is a dangerous and often lethal condition, claiming a quarter million American lives annually, as well as a significant driver of healthcare costs. It is the most expensive hospital condition to treat, accounting for more than $23 billion dollars in healthcare costs annually. In addition, with a growing chronic disease burden that places patients at a greater risk of infections that can lead to sepsis, effective and comprehensive strategies to address sepsis are critical. Read More »

On May 30, the Virginia Senate by a vote of 23-17 and the House of Delegates by a vote of 67-31 approved the expansion of the state’s Medicaid program. With Gov. Ralph Northam expected to approve the legislation, the commonwealth is poised to become the 33rd state to expand its Medicaid program to cover an estimated additional 400,000 low-income adults with incomes up to 138 percent of the federal poverty level (FPL), which is an annual income of no more than $16,753 for a one-person household. The bill authorized the expansion of Medicaid and included provisions requiring the state to submit a waiver to CMS establishing work requirements and cost-sharing requirements for the state’s Medicaid expansion population. If approved by CMS and implemented, Virginia will become the fifth state with work requirements in its Medicaid expansion program, joining Arkansas, Indiana, Kentucky, and New Hampshire. Read More »

Since 2015, legislators in at least seven states, as well as Congress, have introduced 15 bills to finance substance use disorder prevention and treatment activities by imposing a surcharge, tax, or fee on prescription opioids. Read More »

ASTHO is currently tracking a variety of state legislation that expands access to contraceptives through insurance coverage requirements, allows pharmacists to dispense contraceptives, and supports the use of long-acting reversible contraceptives methods. Read More »

Vaccines remain a vital and cost-effective public health intervention to prevent and control diseases, and state legislatures play an active role in developing vaccination laws that balance public health benefits with individual autonomy. As a result, vaccine policies are perennially considered during legislative sessions. Only one month into 2017, and ASTHO is tracking 61 bills from 22 states. Read More »

On Tuesday, voters across the country had the opportunity to influence state policy through ballot initiatives on key public health issues like marijuana use, tobacco taxes, and health system reform. While official results are a few weeks away, the preliminary results are in. Read More »